Transtracheal lignocaine: effective treatment for postextubation stridor.

Three cases of post-extubation stridor due to suspected laryngospasm are described in which a small dose of lignocaine injected intra-tracheally, through the cricothyroid membrane, produced rapid and effective relief of stridor with no early recurrence or side-effects. The procedure was performed safely and quickly and was well tolerated by patients. Trans-tracheal injection of local anaesthetic should be considered for treatment of post-extubation stridor in adults, so long as there is no risk of pulmonary aspiration, and pathological causes of laryngospasm have been excluded.